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KMID : 1134120060090020115
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Journal of Breast Cancer
2006 Volume.9 No. 2 p.115 ~ p.120
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Preoperative evaluation of lymph node metastasis with using ultrasonography for examining the axilla in early stage breast cancer
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Hwang Sung-Eun
Moon Woo-Kyung
Cho Nariya
Han Won-Shik
Kim Sung-Won
Shin Hyuk-Jai
Hwang Ki-Tae
Lee Jeong-Eon
Youn Yeo-Kyu
Oh Seung-Keun
Roh Dong-Young
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Abstract
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Purpose: The axillary lymph node status is the most significant prognostic factor in breast cancer. The development of tools to accurately evaluate the axillary lymph node status with less morbidity has been the important treatment issue. Although sentinel lymph node biopsy is the promising alternative to axillary lymph node dissection, the high false negative rate of this procedure is a considerable problem. This study aimed to evaluate the efficacy of performing preoperative axillary ultrasonography (US) for predicting axillary lymph node metastasis.
Methods: Between January 2003 and December 2004, preoperative axillary US was performed in 646 patients who were suffering with T1 or T2 infiltrating ductal carcinoma and they had no palpable axillary lymph nodes.
Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of preoperative axillary US findings were 82.8%, 93.2%, 86.3%, 91.2%, and 89.6%, respectively. The positive and negative predictive values for performing axillary US findings for tumors with a size ≤2cm were 76.2% and 92.5%, respectively. For tumors with a size >2cm, the positive and negative predictive values were 90.6 and 89.4, respectively.
Conclusion: We found that performing preoperative axillary US is a relatively accurate and useful non-invasive method for assessing axillary lymph node metastasis. It showed the potential to replace sentinel lymph node biopsy in tumors ≤2cm in size with low false negative rate. If we can improve the positive predictive value of US finding by using strict decision criteria, and especially for the tumors >2cm in size, then axillary lymph node dissection might be recommended for the cases with positive US finding. (J Breast Cancer 2006;9:115-120)
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KEYWORD
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Breast cancer, Axillary lymph node metastasis, Ultrasonography
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